Tags

Type your tag names separated by a space and hit enter

[DaVinci robot-assisted laparoscopic prostatectomy: benefit for obese men? - A matched-pair analysis].
Urologe A. 2015 Jan; 54(1):34-40.U

Abstract

BACKGROUND

Open radical retropubic prostatectomy (RRP) in obese patients (BMI ≥30) is associated with increased perioperative morbidity. The aim of the study was to evaluate the possible benefit of DaVinci robotic-assisted laparoscopic prostatectomy (RARP) compared to RRP in obese patients.

PATIENTS AND METHODS

We identified 255 patients with a localized prostate cancer (PCa) and BMI ≥30 treated with radical prostatectomy from January 2009 to December 2011. To adjust for risk factors of increased perioperative morbidity (nerve-sparing, pelvic lymph node dissection, prostate volume), a propensity score-based matching was performed between RRP and RARP (n=115 each group). Both groups were compared by taking into consideration histopathological outcomes as well as peri- and postoperative (30 days) morbidity.

RESULTS

There were no differences in histopathological characteristics (pT/pN-stage, Gleason score, R-stage; all p>0.05) in both groups. Mean blood loss (276 ml vs. 937 ml), transfusion rate (0.9% vs. 8.7%) and 30-day complications according to the Clavien classification system (Clavien ≥ 2; 9.5% vs. 22.6%) were decreased in RARP (all p<0.05). In a multivariate logistic regression model, RARP vs. RRP was associated with a significantly reduced risk of a Clavien ≥ 2 complication during follow-up (OR 0.3; p= 0.0047). Recovery of continence was significantly better for RARP patients after 3 months (p= 0.02). There was no difference in erectile function 12 months postoperatively.

CONCLUSION

Our findings of decreased transfusion and complication rates and a trend of better early recovery of continence in RARP should be considered in obese patients (BMI >30) scheduled for radical prostatectomy.

Authors+Show Affiliations

Martini-Klinik Hamburg, Martinistraβe 52, 20246, Hamburg, Deutschland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
English Abstract
Journal Article

Language

ger

PubMed ID

25214312

Citation

Beyer, B, et al. "[DaVinci Robot-assisted Laparoscopic Prostatectomy: Benefit for Obese Men? - a Matched-pair Analysis]." Der Urologe. Ausg. A, vol. 54, no. 1, 2015, pp. 34-40.
Beyer B, Kühne K, Böhm K, et al. [DaVinci robot-assisted laparoscopic prostatectomy: benefit for obese men? - A matched-pair analysis]. Urologe A. 2015;54(1):34-40.
Beyer, B., Kühne, K., Böhm, K., Schiffmann, J., Heinzer, H., Michl, U., Huland, H., Graefen, M., Haese, A., & Steuber, T. (2015). [DaVinci robot-assisted laparoscopic prostatectomy: benefit for obese men? - A matched-pair analysis]. Der Urologe. Ausg. A, 54(1), 34-40. https://doi.org/10.1007/s00120-014-3589-y
Beyer B, et al. [DaVinci Robot-assisted Laparoscopic Prostatectomy: Benefit for Obese Men? - a Matched-pair Analysis]. Urologe A. 2015;54(1):34-40. PubMed PMID: 25214312.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [DaVinci robot-assisted laparoscopic prostatectomy: benefit for obese men? - A matched-pair analysis]. AU - Beyer,B, AU - Kühne,K, AU - Böhm,K, AU - Schiffmann,J, AU - Heinzer,H, AU - Michl,U, AU - Huland,H, AU - Graefen,M, AU - Haese,A, AU - Steuber,T, PY - 2014/9/13/entrez PY - 2014/9/13/pubmed PY - 2016/1/7/medline SP - 34 EP - 40 JF - Der Urologe. Ausg. A JO - Urologe A VL - 54 IS - 1 N2 - BACKGROUND: Open radical retropubic prostatectomy (RRP) in obese patients (BMI ≥30) is associated with increased perioperative morbidity. The aim of the study was to evaluate the possible benefit of DaVinci robotic-assisted laparoscopic prostatectomy (RARP) compared to RRP in obese patients. PATIENTS AND METHODS: We identified 255 patients with a localized prostate cancer (PCa) and BMI ≥30 treated with radical prostatectomy from January 2009 to December 2011. To adjust for risk factors of increased perioperative morbidity (nerve-sparing, pelvic lymph node dissection, prostate volume), a propensity score-based matching was performed between RRP and RARP (n=115 each group). Both groups were compared by taking into consideration histopathological outcomes as well as peri- and postoperative (30 days) morbidity. RESULTS: There were no differences in histopathological characteristics (pT/pN-stage, Gleason score, R-stage; all p>0.05) in both groups. Mean blood loss (276 ml vs. 937 ml), transfusion rate (0.9% vs. 8.7%) and 30-day complications according to the Clavien classification system (Clavien ≥ 2; 9.5% vs. 22.6%) were decreased in RARP (all p<0.05). In a multivariate logistic regression model, RARP vs. RRP was associated with a significantly reduced risk of a Clavien ≥ 2 complication during follow-up (OR 0.3; p= 0.0047). Recovery of continence was significantly better for RARP patients after 3 months (p= 0.02). There was no difference in erectile function 12 months postoperatively. CONCLUSION: Our findings of decreased transfusion and complication rates and a trend of better early recovery of continence in RARP should be considered in obese patients (BMI >30) scheduled for radical prostatectomy. SN - 1433-0563 UR - https://www.unboundmedicine.com/medline/citation/25214312/[DaVinci_robot_assisted_laparoscopic_prostatectomy:_benefit_for_obese_men___A_matched_pair_analysis]_ L2 - https://dx.doi.org/10.1007/s00120-014-3589-y DB - PRIME DP - Unbound Medicine ER -